Sudden death: what is it and causes

Sudden death is the sudden and unexpected onset of cardiac arrest in a person who is apparently healthy and well. Its main cause is a cardiac arrhythmia called ventricular fibrillation, which causes the heart to lose its ability to contract in an organized way, so it stops beating.

What happens in our body when it appears

First of all, the victim of sudden death loses the pulse and, in a few seconds, also loses consciousness and the ability to breathe. Without immediate attention, the direct consequence is death within a few minutes.

Cardiopulmonary resuscitation measures can in many cases cause the arrhythmia to disappear and the patient to recover. In this case we speak of a “resuscitated or recovered sudden death episode”.

Even so, unfortunately, the vast majority of patients who suffer sudden death and do not receive medical attention die within a few minutes. In Spain there are about 40,000 sudden deaths per year, of which between 40 and 50 occur in young athletes.

Causes of sudden death

Sudden death occurs mainly in three situations:

  • Patients suffering from coronary heart disease. This type of disease is by far the most frequent cause of sudden death, since it is one of the common forms in which an acute myocardial infarction can occur.
  • Young people who suffer cardiac arrest while playing sports. This is a smaller group of patients, but is better known due to its social and media repercussions and, in most cases, the cause of death is genetic.
  • Infants under one year of age. In these cases, the problem is very different and, although the causes are not well known, it is thought that it may be due to the immaturity of the organism to maintain the respiratory rhythm.
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Thus, when we talk about the causes of sudden death we must separate two age groups:

  • Over 35 years of age. The most frequent cause of sudden death is coronary arteriosclerosis and myocardial infarction.
  • Under 35 years of age. The causes are usually hereditary, i.e. genetic or familial heart diseases, of which hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, dilated cardiomyopathy, long QT syndrome or Brugada syndrome, among others, can be highlighted.

It should be noted that most of these diseases can be diagnosed with the performance of an electrocardiogram (ECG), so a very effective preventive measure would be for every young athlete to have an ECG performed and interpreted by a specialized cardiologist. Many of these diseases are included in the group of so-called rare diseases, so their detection and treatment should be carried out by cardiologists specialized in these genetic diseases.